PROJECT SUMMARY/ABSTRACT Dr. Karen Costenbader is a recognized patient-oriented investigator in the epidemiology and outcomes of systemic lupus erythematosus and rheumatoid arthritis, and a very engaged mentor of the next generation of patient-oriented clinical investigators. She has served as primary or secondary research mentor for 40 pre- and post-doctoral research trainees. Along with her position as Director of the Brigham and Women's Hospital Lupus Program, Dr. Costenbader's mentoring is facilitated by her affiliations with multiple Harvard-based institutions and training programs, and with national research and clinical organizations. The candidate's many ongoing patient-oriented research projects and collaborations, high degree of commitment to mentoring and to continuing to improve her mentoring skills, and the exceptional institutional resources, provide an outstanding environment for the development of junior investigators. This K24 grant would preserve Dr. Costenbader's protected time and relieve her of clinical and administrative responsibilities. The new research aims proposed will build upon past work on cardiovascular disease risk among lupus patients. With data on more than 100,000 lupus patients enrolled in Medicaid in the U.S., the new studies will address key unanswered questions about lupus disease heterogeneity and cardiovascular disease risk, with abundant statistical power to detect differences in these serious outcomes. The inherent sociodemographic variation of this population and the high risk of cardiovascular disease in this vulnerable population make these studies extremely relevant for improving care and outcomes for lupus patients. Additionally, validating and refining the 2017 QRISK3 cardiovascular disease risk prediction algorithm in the Brigham and Women's Lupus Cohort will provide patient interactions to collect and verify outcomes, and experience for mentees with developing risk prediction algorithms. The clinical questions to be examined will afford independent projects and publications, experience with advanced biostatistical models for research mentees, and excellent mentoring opportunities. Dr. Costenbader has assembled a strong team of highly qualified co-mentors and she will recruit two to three new trainees into her rheumatic disease epidemiology and outcomes research program annually. She will continue to refine her mentoring program and skills using trainee feedback and the many educational opportunities in her environment. This K24 grant would support Dr. Costenbader's ability to develop the next generation of patient-oriented rheumatic disease investigators.